The blog of a travelling psychiatrist and football lover. Who happens to be a halfway decent photographer. Takes a cynical view of the world

Archive for the tag “USA”

The mosquito borne virus Zika Vius has been linked to over 4000 babies born with serious tragic brain deformities , such as microcephaly, a tiny head and brain. Until recently it was thought this was limited only to Brazil, but evidence supports cases developing elsewhere.

Although there is no definitive proof to link the cases of microcephaly to Zika the evidence seems overwhelming. Normally Brazil reports around 200 annual cases of micrcephaly but since October 2015 over 4000 cases have been reported mostly concentrated in a specific poor region in the north east of Brazil Pernambuco. The virus has also been recovered both in stillborn babies and from the uterus. The evidence thus seems incontrovertible.

Originally it was believed that a specific type of mosquito, Aedes Aegypti, confined to the tropics was the sole type of mosquito that could spread the virus. This mosquito usually bites during the morning and late afternoon/evening hours and is the mosquito that also transmits Dengue, Chikungunya and Yellow Fever. Evidence is now however emerging that the Zika virus may have crossed over to the common mosquito, the Culex mosquito, which is maybe 20 times more common and found widely in The Americas, Asia and Africa. The virus cannot be spread person to person.

The biggest concern is that there is neither a cure nor a vaccine. Zika is thus a huge concern for especially pregnant women who may travel to areas of the world where the disease is active.

In USA the CDC ( Centers for Disease Control and Prevention) have issued a level 2 travel alert meaning that pregnant women may want to delay travel to more than 20 countries in The Americas and beyond where Zika cases have been registered, and some airlines have offered to refund or change tickets for pregnant women in this situation. The WHO have stated that surveillance of Zika as well as the neurological complications should be strengthened.

Pragmatically this means that pregnant women should consider staying away from the 2016 Olympics in Brazil.

Zika Virus Countries of Origin

But what do the symptoms of Zika look like?

Generally the symptoms are vague and generic, typically mild cases of flulike symptoms and a rash. So these can include joint pains, fever, rash, conjunctivitis or there may be no specific symptoms at all. There is also a link to a more potentially severe and sometimes fatal catastrophic neurological illness, Guillain-Barre syndrome that is regarded as an autoimune disorder. This was reported in outbreaks in 2013 and 2015 in French Polynesia and Brazil. Typically most people will not know they have been infected and recover after 2-7 days without any specific treatment. The actual incubation period is unknown but is likely to be only a few days between bite and onset of symptoms.

Diagnosis is through blood sampling for virus isolation and not by serology as Zika can cross-react with other viruses such as Dengue, west Nile and Yellow Fever.

What do we know about the development history of Zika?

The Zika virus is not new even for USA and has been known about since the 1950’s and was named after the Zika forest near Lake Victoria in Uganda where it was first isolated from a captive monkey. The first human case was in 1952 in Uganda.

It has since spread across equatorial Africa and to Asia, Polynesia and South America. The first large outbreak took place in 2007 in the Pacific island nation of Micronesia and a USA subject travelling was stricken down. Essentially travelling Americans have brought the virus back to USA. It is believed that data from 50 State health departments supports that 20-30 cases of Zika have been diagnosed in USA. Reports January 28th include reported cases in Los Angeles who had travelled to El Salvador in 2015, who has since fully recovered, and a Minnesota traveller have had confirmed cases.

On January 27th 2016 the first person in Denmark tested positive for Zika. Other countries that have already registered cases include UK, Spain, Italy and Switzerland.

How to prevent Zika infections?

The biggest concern is that there is neither a cure nor a vaccine and the only known way to prevent infection is to prevent getting bitten by mosquitos using the normal routes including:

Using DEET insect repellant

Protective clothing

Avoiding areas of specific large amounts of mosquitos

Mosquito nets in an endemic area

Empty, clean or cover water containers ( such as flower pots, buckets etc) where mosquitoes can breed

Also an awareness that this mosquito usually bites during the morning and late afternoon/evening hours.

There have also been warnings in some Latin American and Caribbean nations for women to delay pregnancy until more is known. These countries include Colombia, Ecuador, El Salvador and Jamaica. However it has also been pointed out that widespread contraception is also not always available and abortions in some countries is illegal, making things complex to fully interpret.

The CDC advice for pregnant Americans to avoid travelling to the 20 or so countries where Zika is likely seems reasonable at the current time.

As a football fan I see plenty of occasions each game where the officials get it wrong and sometimes badly so. Having said that players and managers also are culpable of making errors plenty of times in any given game. I do however take a view that officials should be allowed to do their jobs with the expectation that they will not be perfect and certainly should be protected from on-pitch haranguing and demonstrations of anger on the pitch itself. At the recent Met Police v Kingstonian game at half time, immediately before which Met Police had scored direct from a corner, the officials were approached by the Kingstonian manager Tommy Williams clearly angry at some percieved error of judgement, and in a finger waving manner. We all in non-league should have respect for the officials and I personally cannot condone this behaviour. I am sure there are other views out there and it would be interesting to hear them.

Firstly please share this post with friends and colleagues. What I am about to describe is a worrying trend and one that I would not like to see expanding. A kind of “legal ” vigilante going under the euphemism of ” Environmental Enforcement”. OK. Picture the scenario. A short one hour visit to Wimbledon and returning to the train station and about to enter. What did I visualise?

I am appalled. There are three I will call them officers with the gentle demeanour of harsh traffic wardens crossed with prison wardens who are ticketing folks under the name of environmental enforcement. Their crimes? Seems throwing cigarette ends anywhere than some specific receptacle. Fixed penalty fines of 75£ or 80£. Those being questioned had a poor grasp of the English language. Apparently this is a criminal offence to throw cigarette ends away like this as one officer explained.
My views on this were heavily influenced by recent reports that police no longer routinely investigate burglaries. And around 10 yards away a homeless man was prostrate and sleeping and would have been a better beneficiary of their wise input and assistance. One might also argue that folks needing help such as this man might be better recipients of environmental protection than inadvertent or even deliberate throwing of cigarette ends on the ground outside a station . Am I right to be angry about this?

After a little research tonight it seems Merton Council have a zero tolerance to littering, or so they say. The wording from their website tells us this

“Due to the high number of pedestrians visiting the town centre, Wimbledon has the highest rate of cigarette litter in Merton with over 1,500 FPNs being issued since June. As well as taking a zero-tolerance approach to enforcement, the council works to educate residents and visitors to the borough about environmental crime and the likelihood that they will be fined £75 for littering”

What however is worrying is that there is no right of appeal against a fixed penalty notice. So we all understand the situation that littering is not a good thing and the majority of us would agree that we should do it. However there are limits. And those limits to me are exceeded by seeing in practice that people who were it seems unaware of this draconian zero tolerance to cigarette ends, and we are not talking about littering huge amounts of kebab shop waste or newspapers on the streets, but cigarette ends, are being fined what seems an excessive amount. Furthermore to see a homeless man prostrate, rather curiously by a gritting bin, and these environmental enforcement officers take no action in the 15 minutes that I observed them was to say the least disheartening. That ” society” , well the council , cares more extracting punitive fines than humane care, speaks volumes.

The next aspect that we need to address is the actual environmental enforcement officers. Their attire of a kind of jump suit more often associated with prison, with their waists surrounded by more equipment than many would need to climb Mount Everest or contain a whole ward of rioting patients in Broadmoor, seems excessive to say the least. Together with mounted CCTV on their uniforms. I am sure Neil Armstrong had less equipment when he set foot on the moon with Apollo 11 in july 1969.

Many or even most of these officers it seems are supplied by a company called Kingdom. A press release from March 2014 stated that the council’s own enforcement officers will work alongside the Kingdom enforcement team from the end of April as they go out and about around Merton to make sure the borough is kept litter-free. Kingdom’s team is led by ” experts with an ex-military and police background”. Quite why this is so necessary to deal with ordinary folks who have thrown cigarette ends on the ground is not so clear. They issue these fixed penalty notices to those breaking the Environmental Protection Act 1990.

Where it however gets more interesting is that Merton Council has come under fire for reducing street cleaning in town centres on Sundays – while spending nearly £130,000 a year on four environment enforcement officers. So photographs published in March 2015 show far worse littering caused by the overflowing of these bins than I certainly visualised on the pavements of Wimbledon. In fact I saw nothing other than the poor homeless man. There is a lot of information provided by the government on how councils can issue FPNs and also how they should use the funds accrued.

The same site above lists the various offences for which FPNs can be given and it is immediately obvious that some of these are serious and should be punished in a punitive manner, however in the context cigarette ends must be at the lower if not lowest end of the spectrum.

graffiti
littering
fly-posting
nuisance parking (people selling or repairing cars on the road)
dog control offences
abandoned vehicles
leafleting without permission on land where leafleting is restricted (‘designated land’)
failing to nominate a key holder or give the council key holder details in an alarm notification area
failing to provide a waste carrier licence (for businesses transporting their own waste)
failing to provide a waste transfer note when moving non-hazardous waste

There is a world of difference between for example “littering” with an abandoned vehicle and a cigarette end. Yet the difference in fine amounts is surprisingly small. £200 for abandoning a car and £75 for abandoning a cigarette end. The money must also be put to specified uses.

So what I am left wondering is what training is given to these officers, what degree of latitude do they have in not administering a FPN, if they have any targets, and of course how much money is raised and exactly to what purpose is it put. There is clear guidance on publishing not only the enforcement strategy but also to how the money will be used.

So in my world there would be some degree of spectrum here on exactly what constitutes a littering offence and throwing a single cigarette end does not equate to toxic pollution of the planet. Maybe also these officers can not only look at the bigger picture, but as today adopt a more humane approach. To have allowed that homeless man to remain on the ground lying prostrate would not be their greatest achievement in their day. Littering does have context and we need to be careful not to be too literal and punitive. If Merton Council want and feel they should adopt a zero tolerance approach, then this should be reflected in not only this aspect but all aspects of their work. Finally what exactly are they doing with the money, that was not happening before? I have developed a zero tolerance approach to not knowing the answers to these reasonable questions.

I am just impressed by what a few lessons in GCSE photography have taught the 15 year old. Here you see the original photograph and what was created with about 20 minutes work. Soon she will be wanting paid commissions…and why not

Brentford came into this game on the back of a four game winning run and faced a physical Hull side with the menacing Steve Bruce prowling on the touchline. The simple reality were that Bees had a few chances in the first 10 minutes of which they should have taken at least one, but then the first half somewhat became an even game. The second half Hull upped the ante and made some decent substitutions and took the game away from Brentford with a combination of good technique and excellent finishing. David button would not reflect upon this game as his best for Brentford and the second Hull goal would usually not have happened with a spilling of the ball to the feel of the hull striker. hull however are an excellent side and move top of the championship after this victory and i would be unsurprised to see them there next May.

There was no shame in losing to the better side. The Brentford perfomance was good and the team are improving game by game. Do we have any concerns? Not really. Maybe the substitutions did not help last night. Taking Toumani off for me is never a good thing for whatever reason. KK runs a lot, has good positional ability but frankly lacks the technique for a good championship player and without being negative I can see him on his way to League 1-2 level in due course. Ryan woods looks younger each game but improves each game with immense workrate. Yennaris has settled, in my view surprisingly, at right back and also improves each game, but maybe still could elevate his general work rate. Some of his central defending was also excellent last night leading me to wonder if he might also be an option there.

Griffin Park under floodlights is something I will miss as there always is a special atmosphere and a midweek crowd on a dull and damp night of 9200 is excellent. Lastly it was good to see Sam Saunders back on the bench. He will play cameo roles one suspects but a good option to have.

Just to showcase three superb photos of very different topics that were not taken by myself. Enjoy. I wish I had the opportunity to do GCSE photography.

The simplicity of a Kit Kat against the sports pages of The Sunday Times. Red and white.

A cat seemingly wanting to eat an almond croissant.Cumberleylaude, a ‘gourmet cat’ with a love of fine dining, could join stage show CATS after discovery of lost TS Eliot poem. Is this the first audition for the role?

A good game of football. A single goal separated the two teams but in relaity it could have been 3-3. The football was good. The cheeseburger was too. Am not sure of the FA rules after a player is sent off but not sure he should be watching from the touchline even if he does take his shirt off! the crowd was 95, so he made it 96.

The last time Brentford beat QPR was in 1965 and not so many of the capacity crowd last night were even born then. This game was thus a time for celebration. A capacity crowd of over 12,000, some useful money from Sky for live coverage, and the fourth consecutive victory in a season when 2 weeks ago some wondered if we would win 4 games all season. All achieved with eseentially the same players. There is no need to give a match report and all Bees fans were there or watching on TV. A high tempo game, maybe too scrappy in parts. If I were a betting man i would place good money, and lots of it, on QPR not only failing to gain promotion this season but also failing to get in the play offs and sacking their manager certainly this side of xmas.

Some of the peripheral things around a capacity crowd caught my eye last night. How good does Griffin Park look under lights, how scary burger sellers can look ( a lovely man actually and a nice burger too) and the strange things one finds on top of cars parked in the Watermans car park .

The firework or whatever incendiary device it was certainly lit up Griffin Park after the goal. A great night. What price a second victory at Loftus road later on in the season?

An amateur contender but excellent scones. Is there any better smell than homemade baking? These photographs were taken some time ago and have been sitting on my desktop computer. The TV series has clearly rekindled excitement in baking again and even Nigella Lawson has said that the creations on TV are beyond her skills. Enjoy.